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Lipoprotein (a): a historical appraisal
Karam M Kostner1, Gert M Kostner2
1Department of Cardiology, Mater Hospital and University of Queensland, Brisbane, 4101 Queensland, Australia.
Journal of Lipid Research
|November 9, 2016
Summary
Lipoprotein (a) [Lp(a)], initially thought to be a variant, is present in everyone. Its variable levels are due to genetic factors, impacting coronary heart disease risk and driving current research.
Area of Science:
- Cardiovascular Science
- Genetics
- Biochemistry
Background:
- Lipoprotein (a) [Lp(a)] was initially considered a genetic variant of Lipoprotein (Lp)-B.
- Due to its lipid similarity to LDL, Lp(a) was deemed highly atherogenic.
- Early detection linked Lp(a) positivity to increased coronary heart disease (CHD) risk.
Purpose of the Study:
- To explore the historical understanding and evolving research landscape of Lipoprotein (a).
- To highlight the genetic basis and variability of Lp(a) concentrations.
- To underscore the ongoing research interest driven by new therapeutic strategies.
Main Methods:
- Historical review of Lp(a) detection and characterization.
- Genetic analysis of apo(a) alleles and their role in Lp(a) size heterogeneity.
- Epidemiological studies utilizing quantitative Lp(a) monitoring.
Main Results:
- Lp(a) is universally present, with concentrations varying significantly among individuals.
- Genetic factors, including apo(a) allele variations and mutations, dictate Lp(a) size and plasma levels.
- A historical cut-off of 30-50 mg/dl for myocardial infarction risk assessment is still used in studies.
Conclusions:
- Lp(a) research is experiencing a resurgence due to novel therapies targeting its reduction.
- Despite advances, significant knowledge gaps remain regarding Lp(a) function and metabolism.
- Understanding Lp(a) genetics and variability is crucial for cardiovascular risk assessment and therapeutic development.
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